Healthcare Claims & Benefits Configuration Analyst (Facets)

Healthcare Claims & Benefits Configuration Analyst (Facets)

Location : 4000 Luxottica Place Mason OH 45040 (Hybrid 2 days per week onsite)

Duration : 3 Months with possible extension

Work Hours : 8 AM to 5 PM EST (1-hour break; 40 hours / week)

Pay Rate : $50-55 / hr. W2 All Inclusive

Role Overview

Serve as a Sr. Configuration Analyst on the Business Configuration Solutions team. Responsible for the enablement of member benefit configuration strategies by designing implementing and executing configuration. Lead projects for the Configuration space to enable system and process solutions for Business Configuration tool sets.

Key Responsibilities

• Serve as a subject matter expert for the Business Configuration team supporting EyeMeds cross-functional teams to implement client requirements.
• Lead / represent cross-functional meetings and capture business requirements.
• Serve as a subject matter expert representing the Configuration workstream for large Government Implementations for Medicaid Med / Surgical and Medicare programs .
• Provide data analysis and troubleshooting expertise on configuration tool sets with automated processes .
• Prepare data for analysis by removing duplicates errors and outliers; perform data validation .
• Build SQL queries to pull backend data based on configuration needs.
• Serve as a Business Analyst documenting requirements process flows and executing testing for enhancements to improve the automation toolset.
• Perform Fit / Gap Analysis and feedback assessments for new client plans.
• Collaborate with leadership on configuration roadmap deliverables and automation of EyeMeds product and network offerings.
• Self-manage and prioritize to meet SLAs and KPIs.
• Build and maintain strong stakeholder relationships across EyeMed.

Must-Have Qualifications

Preferred Qualifications

Education

CANDIDATE SELF-ASSESSMENT : SKILL QUALIFICATION MATRIX

Please fill out the below matrix while applying. Use a scale of 1 (Beginner) to 10 (Expert) for the Self-Rating column.

Skill Category

Required or Preferred

Self-Rating (1-10)

Years of Experience

Notes / Comments

Facets Platform

Required

Healthcare Claims Knowledge

Required

Benefit Configuration

Required

SQL / Database

Required

Oracle SQL

Required

Medicaid Product Configuration

Required

Data Analysis & Troubleshooting

Required

Cross-Functional Leadership

Required

Process Documentation

Required

Testing & Validation

Required

Informatica / Automation Tools

Required

Medicare Knowledge

Preferred

Medical Plan Configuration

Preferred

Provider Network Configuration

Preferred

Communication & Interpersonal Skills

Preferred

Self-Prioritization / SLA Delivery

Preferred

Key Skills

Civil,Apparel,Banking,CMS,Insulation

Employment Type : Full Time

Experience : years

Vacancy : 1